| NPI | 1609909282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUANN GANZ Office Manager 208-664-5467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M8313) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2015-05-04 |